Kikuyama Masataka, Kamisawa Terumi, Kuruma Sawako, Chiba Kazuro, Kawaguchi Shinya, Terada Shuzo, Satoh Tatsunori
Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan.
Department of Gastroenterology, Shizuoka General Hospital, Shizuoka 420-8527, Japan.
Cancers (Basel). 2018 Feb 11;10(2):48. doi: 10.3390/cancers10020048.
Pancreatic cancer (PC) has a poor prognosis due to delayed diagnosis. Early diagnosis is the most important factor for improving prognosis. For early diagnosis of PC, patients with clinical manifestations suggestive of PC and high risk for developing PC need to be selected for examinations for PC. Signs suggestive of PC (e.g., symptoms, diabetes mellitus, acute pancreatitis, or abnormal results of blood examinations) should not be missed, and the details of risks for PC (e.g., familial history of PC, intraductal mucin producing neoplasm, chronic pancreatitis, hereditary pancreatitis, or life habit) should be understood. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) can be performed for diagnosing PC, but the diagnostic ability of these examinations for PC is limited. Endoscopic diagnostic procedures, such as endoscopic ultrasonography, including fine-needle aspiration, and endoscopic retrograde pancreatocholangiography, including Serial Pancreatic-juice Aspiration Cytologic Examination (SPACE), could be recommended for a detailed examination to diagnose pancreatic carcinoma earlier.
胰腺癌(PC)由于诊断延迟,预后较差。早期诊断是改善预后的最重要因素。对于PC的早期诊断,需要选择有PC临床表现且有发生PC高风险的患者进行PC检查。不应遗漏提示PC的体征(如症状、糖尿病、急性胰腺炎或血液检查异常结果),并应了解PC的风险细节(如PC家族史、导管内黏液性肿瘤、慢性胰腺炎、遗传性胰腺炎或生活习惯)。多层螺旋计算机断层扫描(MDCT)和磁共振成像(MRI)可用于诊断PC,但这些检查对PC的诊断能力有限。对于早期诊断胰腺癌的详细检查,可推荐内镜诊断程序,如包括细针穿刺的内镜超声检查,以及包括连续胰液抽吸细胞学检查(SPACE)的内镜逆行胰胆管造影。